Evaluation of the Informal Caregiver Burden in the Care of Stroke Patients at Kenyatta National Hospital

Abstract

Background: Most stroke survivors return home after discharge and the burden of caring for them falls on their families. These informal caregivers have higher risks of mental and physical illnesses.

Objective: To determine the level of informal caregiver burden of stroke patients at Kenyatta National Hospital (KNH).

Methods: This was a cross sectional study at the KNH Neurology clinic, physiotherapy unit, cardiac clinic and medical wards. One hundred and thirty five informal care givers identified in the clinic and the wards were interviewed with pretested questionnaire. Informal caregiver burden was evaluated using ZBI questionnaire and depression using PHQ9 Test Questionnaire. It was analyzed using SPSS software version 21.0. Demographic and clinical characteristics of the study sample were summarized using means (standard deviations) or medians (interquartile range) for continuous variables and number (percentage) for categorical variables. Descriptive analysis was made to assess knowledge of caregivers and relationships between independent variables in both stroke survivors their caregivers and level of burden. Level of burden is expressed in proportions and distributed between physical, psychological, social and financial burden. Results are presented as numbers and percentages. Relationships between categorical variables (socio-demographics) were analyzed using chi square. Comparison of means (age) used student t-test while medians (duration of stroke and care giving) were compared with Mann Whitney u test. Confidence intervals were 95% with p value <5% being significant

Results: Their mean age was 36.2 years with 54.5% females. The stroke caregivers were: adult offspring 50.7%, spouses 24.1% and siblings 13.8%. 47.6% of the care givers had moderate to severe depression. The level of informal caregiver burden was found to be moderate in 58.6% (CI 50.3%-66%). The major factors that contributed to burden were financial, social and psychological. The caregiver factors were daughters, being employed, shorter duration of care giving and depression. The patient factors were higher levels of disability, shorter duration of stroke, lack of health insurance and single. There was little preparation of caregivers prior to discharge.

Conclusion: There is need to institute measures for preparation and support of caregivers.